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NIHR Global Health Research Unit on Diabetes and Cardiovascular Disease in South Asians

Principal Investigator: Professor John Chambers (Medicine)

Business School Investigator’s: Dr Marisa Miraldo & Professor Franco Sassi

Funder: National Institute for Health Research (NIHR)

Duration: September 2021 – August 2026

Summary

Diabetes and heart disease are leading causes of death and disability worldwide, and are especially common amongst people living in South Asia (Bangladesh, India, Pakistan and Sri Lanka). The impact of diabetes and heart disease on South Asian people is magnified by the limited access to high quality health care. Diabetes and heart disease are thus recognised as high priority public health challenges requiring urgent action across South Asia.

Our Global Health research work aims to improve understanding of the mechanisms underlying diabetes and heart disease in South Asian populations, and to improve prevention and control of these diseases through personalised and health systems based interventions. Our research will be pursued in four complementary, interconnected themes that build on the work carried out to date:

Theme 1. We will determine the health outcomes for 150,000 South Asian men and women, who were initially comprehensively assessed in 2018-21, and who have agreed to be followed long term. We will identify people who have developed diabetes or heart disease since first seen. The dataset created will allow us to study how the risk of diabetes and heart disease varies across South Asian communities, and to identify the lifestyle (eg diet and physical activity), environmental (eg access to healthy food), genetic and metabolic factors that drive diabetes and heart disease in South Asia.

Theme 2. Here we seek to improve health amongst high risk individuals using digital platforms to promote weight loss and improved lifestyle. We will study ~6,000 South Asian men and women with obesity, and determine how digital applications delivered through a smartphone application improve measures of heart and metabolic health, compared to normal care.

Theme 3. This theme aims to strengthen health systems, through training and improved co-ordination of clinical care. We advance a multifaceted ‘Health Hub’ that delivers training, education, collection and sharing of clinical data, support for diagnosis and decision making, and delivery of clinical care. In doing so, we collaborate with the WHO, to help advance international standards for generalisable, evidence based digital health systems.

Theme 4. We will evaluate community-wide intervention for health promotion in South Asia, in partnership with Health Promotion Bureau, Sri Lanka. The intervention adopts a ’whole of society approach’ though community- and policy-based actions, to improve the settings in which people and their families live.

Our research focusses on a major health need for the people of South Asia. We will improve understanding of the causes for diabetes and heart disease in South Asia, and inform strategies for early detection and improved prevention. Our innovative approaches to health promotion and care delivery use platforms that are scalable, sustainable, effective and equitable. Our research has been co-designed with communities, policymakers and healthcare providers in South Asia, and are based on strong pilot data. The findings of our research offers the prospect for a major change in health promotion and disease prevention for South Asians, who represent 25% of the world’s population.